Strategies

Women of childbearing age need accurate, objective data in order to make informed choices about birth settings and providers. The Birth Survey, a mechanism to share, systematically track, and retrieve up-to-date information about the quality of care received will equip consumers with the information necessary to make informed decisions and enable individuals to play a larger role in determining their care and to make real informed health care choices.

The “Resource Wall” will give families the information they need when they need it and not after. It will be located in area obstetrician offices and include information about pregnancy, birth, newborn care, VBAC, finding a doula, local La Leche League meetings, circumcision, community pregnancy services, “Happiest Baby on the Block,” The International Cesarean Awareness Network, vaccinations, and much more. This will be accomplished through the use of community resources and local partnership.

Our goal is to reduce the unnecessary induction and c-section rate in the US. This first project is meant to raise awareness and consciousness to the mainstream public. Our desire was for an event on such a mass scale that all major media outlets would pick up the story and continue to do stories both before and after the event.

As part of a larger program to achieve zero preventable birth injuries, this project’s goal was to avoid tachysystole or appropriately intervene when tachysystole occurred. Tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a 30-minute window, and is often associated with induced or augmented labor.

Group Prenatal Care was started around 2001-2002 and we offer 12 groups yearly. Baby groups were piloted in the 2005 timeframe and packaged/started in 2007. We have done multiple national presentations on group care at organizational meetings.

As a Patient-Centered Maternity Home, two components of our Maternal-Child Health Care are evidence-based practice and shared decision-making. While ACOG guidelines are not always evidence-based, they have recently released guidelines allowing us all to offer trial of labor to women with two prior cesareans or twins. Our cesarean rate is 19% and our VBAC rate is 50%. North Carolina Medicaid is currently reimbursing cesarean birth at the same rate as vaginal birth.They were proactive in setting the rates pretty close to each other in years past.

The Safe Motherhood Quilt Project, originated by midwife Ina May Gaskin, is a national effort developed to draw public attention to the current maternal death rates, as well as to the gross underreporting of maternal deaths in the United States. The Quilt honors American mothers who have died of pregnancy or childbirth related causes since 1982, the last year there was a reduction in maternal mortality.

The goal of the Safe Motherhood Quilt Project is to demand an equivalent system of counting, analyzing, and learning from mistakes made in our maternity care system here, regardless of where babies are born or what caregiver is the birth attendant. Until we do that, doctors, midwives, and nurses in the US will continue to work without a good system of feedback about what is and is not dangerous in maternity care, and preventable maternal deaths will continue to take place.

The improvement team altered the process of care in the operating room to enable routine, early skin-to-skin contact after cesarean birth, with the aim of increasing the success of breastfeeding initiation.

We want to change childbirth options in our area. Of the five local hospitals in our area only one will allow planned VBACs. Also, the c-section rate for first time moms with no complications during pregnancy is an average of 33% in our area. We want to change this! So we are reaching out to the pregnant and new moms in our area by hosting a monthly support group where we focus on the topic surrounding childbirth and the options that are actually available to them. We look to make a change one mom at a time and build a community of families that support each other and empower each other.

For all scheduled cesarean deliveries, the hospital introduced a preoperative checklist to verify patient identity, indication for caesarean section, allergies, and presence of neonatology staff and a postoperative check to verify analgesia, oxytocic prescription, antibiotics, thromboprophylaxis and skin contact between mother and baby. Researchers examined staff attitudes before and after introduction of the checklists, checklist compliance, and whether patients experienced anxiety or were reassured by the process.